Town Square

Do You Travel to a Foreign Country for Major Medical Care?

Original post made
by The Palo Altan next door, Another Palo Alto neighborhood,
on Dec 20, 2006

I can't take this anymore. I am sick of the paperwork nightmare, of being chronically sick because I'm not able to fully get the care I really need even though I am insured, sick of fighting, fighting, fighting (and not always winning) so that my family is not bankrupted by the care I do get. I'm pretty sure our broken health care system won't be fixed in time for me and my family.

I'd like to know if I have options for major medical care in other countries. Someplace I can go with my family, get reasonably good care and follow up, pay a rational amount of money, and avoid years' worth of bureaucratic nightmares afterward.

It sure seems like the care even in places like Australia is cheaper (in full) than even my copays are here, and I won't have to drown in this paperwork. (Please read this New York Times article if you aren't familiar Web Link -- it's hard to believe how bad it is if you have never been through it.)

Do you know foreign countries/hospitals where Americans can go and pay a rational amount of money for high quality health care, especially in countries closest to home or where travel is easiest and safest? (Please provide details of how the financial end is managed for foreigners if you can.)

Posted by Chris
a resident of Old Palo Alto
on Dec 20, 2006 at 9:09 pm

I agree that the morass of bills and EOB's can be bewildering if you have had some major medical problems. However, having been through a complex hospital stay for my wife, I think New York Times article may be exaggerating a bit. Most insurance companies have an ombudsman, or someone you can call to guide you through complex cases - which isn't even mentioned by the Times. I found Stanford Hospital also very helpful.

And since you are willing to pay money for a trip to another country, you might consider one of the paid consultant/negotiators whose business it is to deal with providers and insurance companies in cases like yours - usually for a percentage of any savings. They'll negotiate with the insurers for you, and often negotiate lower bills from providers. (A friend of mine whose uninsured father (from another country) had a heart procedure at Stanford done, and one of these serviced negotiated about 50% off his total bill.)

If you really have insurance, you should come out OK financially. And you won't find better care than we have in the US.

Posted by The Palo Altan next door
a resident of Another Palo Alto neighborhood
on Dec 20, 2006 at 9:37 pm

I'm glad you have had an exemplary experience, Chris, but my experience has been worse than the New York Times article. Based on what I know of many other people, I would say if anything the article creates awareness, it doesn't come close to describing the nightmares "millions" (per the article) of people are put through. Some conditions are well-dealt-with in our system, some or not. I've experienced the former. I happen to now be dealing with the latter.

I have insurance, yet have unreimbursed costs (or insurance-paperwork fenagled losses) of $25,000-50,000 per year and have for the last 15 years. I am still fighting for coverage over necessary care that cost our entire annual income for that year. Insurance has made a tidy sum of interest on my money in the meantime, and as of right now, there is no (positive) end in sight. My family has NOT been okay financially for the past few years because of this. In the past, insurance has sometimes covered, sometimes partially covered, and once not at all after years of hideous battles. Same care, same condition.

Don't you know that half of all personal bankruptcies now are the result of health care costs, and that the majority of those people had health care at the start of the illness that bankrupted them? Bankruptcies for health care costs are virtually unknown in the rest of the developed world.

I would like to use the energy I get from the improved health to have something of a life.

If you have had an exemplary experience, good for you, but unless you can share it somehow with the rest of us, I really need some leads on how I can get the care I need elsewhere. Thanks!

Posted by The Palo Altan next door
a resident of Another Palo Alto neighborhood
on Dec 20, 2006 at 10:39 pm

Pete,
I thought you were joking about Cuba, but apparently they are one of the top countries for "medical tourism":Web Link

I read something in Reader's Digest that the U.S. used to be a top destination for people from other parts of the world, and has lost the majority of that business. The more recent articles on medical tourism all seem to be about Americans going overseas for care. Where do I get specific information?

Posted by Hulkamania
a resident of Duveneck/St. Francis
on Dec 21, 2006 at 10:01 am

Surprisingly Mexico has developed a good reputation for good medical care at a very low price. I read stories about a number of areas that have become huge American retirement communities driven partially because of good cheap medical care.

If you're looking for specific procedures, take a look at Bumrungrad Hospital in Thailand. Web Link 60 Minutes featured them in a story about offshore medical care.

Posted by The Palo Altan next door
a resident of Another Palo Alto neighborhood
on Dec 21, 2006 at 5:17 pm

tried them,
There was a time when I could have blamed everything on insurance, but I'm also seeing some providers (mostly labs and large institutions) work the paperwork morass to get windfalls. Of course "paperwork" is a pretty clinical term for the nightmare this presents for my time, energy, family life, and finances. It's worth traveling to get away from even if I end up paying slightly more because I will have reclaimed my time and peace of mind.

When you say you have "tried them", are you comfortable elaborating? I may be able to swing frequent flier miles from a relative, and we have friends and family to stay with in far flung places. I would, frankly, be more comfortable getting care in Europe (perhaps Eastern Europe?) or Thailand, but Mexico would be easier. Hulkamania, do you have any links about care in Mexico? Especially just over the border?

If I could get the actual cost of the care down to, say, 1/4 to 1/3 of the cost here, it would be worth it if the care is good, and there is no more paperwork. If the cost were less than that, it would be a no brainer. 1/4 is what I pay for copay anyway, and often with all the (surprise!) exclusions I end up paying far more.

Posted by Hulkamania
a resident of Duveneck/St. Francis
on Dec 21, 2006 at 11:26 pm

All of my info is third hand through Latitude 38, a San Francisco area sailing magazine. They have reported numerous instances where there has been an emergency and the Mexico medical system has taken care of it for little or nothing.

They've also reported on people that have moved to Mexico and are extremely happy with the medical care they've received.

Posted by The Palo Altan next door
a resident of Another Palo Alto neighborhood
on Dec 22, 2006 at 12:05 am

-Oops!

I meant to write above (correction in Caps):

Don't you know that half of all personal bankruptcies now are the result of health care costs, and that the majority of those people had INSURANCE at the start of the illness that bankrupted them? Bankruptcies for health care costs are virtually unknown in the rest of the developed world. (Another measure of how insurance is not doing its job.)

Thailand and India get talked about a lot for medical tourism, but I've also seen several references to Costa Rica. If I were in your situation, I'd look into Costa Rica for a chronic condition because it is closer to home. As a bonus, it has a reputation for being a very beautiful place to visit.

Posted by tried them
a resident of Downtown North
on Dec 22, 2006 at 9:22 am

Only inasmuch as a citizen of the UK or Australia has free healthcare in both countries due to reciprocal agreements between the countries. And I've used both.

A lot more people are using private healthcare (such as BUPA) in both countries. In Australia you get a tax penalty if you don't take out private insurance and are earning over a certain threshold. However, "private" can just mean covering the cost of anything in addition to what is provided for free. So it's difficult to compare.

If you just search for "private health treatment united kingdom" you can find sites that provide quotes for these sorts of things both for domestic and international patients. At least it would give you an idea of the costs.

On the insurance side, what I meant by "well insured" was getting 100% coverage for hospital treatment - obviously this pushes up the premiums. I can understand that even 25% of the fees over here would be exorbitant.

Posted by joyce
a resident of Crescent Park
on Dec 22, 2006 at 5:14 pm

Anyone who thinks having insurance means they get good health care in the US hasn't worked for hp. I spent a year trying to get an expensive prescription med that my doctor and specialist both said I needed to avoid cardiac problems paid for by them. They kept sending me in circles, and finally I called hr and hr looked into the runaround and told me that there was no way they were going to pay for it.

I was dumb enough to pay the U.S. med cost for the year I was being sent in circles, thinking for sure they would grant my appeal and reimburse that. I wish I had started out getting the med from Canada and saved myself that money, as I do now - 50% less cost. It's still expensive, but at least I don't have to deal with not being treated like a human being.

Posted by Stella
a resident of Palo Alto Hills
on Dec 29, 2006 at 1:48 am

Do not go to Eastern Europe for medical care; the care is quite basic, and standards of hygiene leave a lot to be desired. Based on personal experience, France, Germany, Sweden, and the UK are pretty good deals, but the best in these countries does not match the best available to the wealthy in the US.

Thailand, India, and the like reportedly have US trained doctors which, one would hope, means they offer well qualified care.

Posted by The Palo Altan next door
a resident of Another Palo Alto neighborhood
on Dec 29, 2006 at 6:19 pm

Thanks for the advice and the good wishes, Stella.

I hear there are US clinics operating just over the border in Mexico -- I can't seem to find any specifics. I hear both very good and very bad things, so it seems like that's a real buyer beware situation -- I wish I could get leads on a good place to get care. What about US clinics in San Diego that may be able to hire day workers from across the border, and maybe even have to compete with pharmacies across the border -- would they be any cheaper?

I had Lasik done in Canada several years ago. The whole operation, plus transportation and lodging, was less than half of what I would have paid in the US for the surgery only. And the whole cost was covered by my medical spending account. I did do a lot of research ahead of time, though, but it paid off.

Posted by Hulkamania
a resident of Duveneck/St. Francis
on Jan 4, 2007 at 4:54 pm

CNBC ran a story today about a number of Southern Cali companies that offer an alternate medical plan that uses doctors and clinics south of the border. It saves the companies and employees a huge amount of money.